Use of the Triple Test at the Breast Screening Center for Patients with Breast Mass

PURPOSE: Breast mass - the most common occurences in the breast must be managed by a method that provides both the best medical and cosmetic results. METHODS: Two hundred seventy-eight patients evaluated and managed for breast mass at our center between January 1998 and December 1999 were analysed. In this study, we compare the results of the triple test score (TTS; sum of physical examination, mammography, and fine needle aspiration cytology) with those from each separate diagnostic test according to a standard formula incorporating sensitivity, specificity, positive predictive value, and negative predictive value. The TTS was modified to substitute sonography for mammography-TTSs. The TTS was also compared to the TTS-2 that double weighted the results of fine needle aspiration (FNA), but was otherwise the same as the TTS. RESULTS: The sensitivity and specificity of breast sonography were 90% and 84% whereas those of mammography were 84% and 73%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the TTSm (triple test score-mammography) were 99%, 97%, 99% and 97% respectively. The scores of the TTSm-2 were 99%, 100%, 100% and 97%. And those of the TTSs were 100%, 100%, 100% and 100%. CONCLUSION: The TTS was more accurate than each of the elements separately in evaluating breast masses. The TTSs was also more effective than the TTSm. The TTS-2 was more useful than the TTS, being less likely to miss malignancy due to the high accuracy of FNA.

Use of the Triple Test for the Patients with Palpable Breast Masses / 한국유방암학회지

PURPOSE: Breast mass - the most common occurences in the breast must be managed by a method that provides both the best medical and cosmetic results. METHODS: Two hundred seventy-eight patients evaluated and managed for breast mass at our center between January 1998 and December 1999 were analysed. In this study, we compare the results of the triple test score (TTS; sum of physical examination, mammography, and fine needle aspiration cytology) with those from each separate diagnostic test according to a standard formula incorporating sensitivity, specificity, positive predictive value, and negative predictive value. The TTS was modified to substitute sonography for mammography-TTSs. The TTS was also compared to the TTS-2 that double weighted the results of fine needle aspiration (FNA), but was otherwise the same as the TTS. RESULTS: The sensitivity and specificity of breast sonography were 90% and 84% whereas those of mammography were 84% and 73%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the TTSm (triple test score-mammography) were 99%, 97%, 99% and 97% respectively. The scores of the TTSm-2 were 99%, 100%, 100% and 97%. And those of the TTSs were 100%, 100%, 100% and 100%. CONCLUSION: The TTS was more accurate than each of the elements separately in evaluating breast masses. The TTSs was also more effective than the TTSm. The TTS-2 was more useful than the TTS, being less likely to miss malignancy due to the high accuracy of FNA.

Primary Experience with Oxaliplatin Chemotherapy for Recurrent and/or Metastatic Colorectal Cancer

PURPOSE: In the past 30 years, the chemotherapeutic approach to advanced colorectal cancer has remained major challenge. Fluorinated pyrimidine has been the main active drugs, and cisplatin was introduced under clinical conditions. Because of the renal and hematologic toxicity of cisplatin, oxaliplatin was developed. The purpose of this study was to assess the clinical response to and the side effects of oxaliplatin chemotherapy. METHODS: From January 1999, 11 patients who received oxaliplatin chemotherapy entered this study. There were 9 males and 2 females, and their ages varied from 40 to 71 years old. The mean ECOG scale was 1. According to TNM staging, 2 was stage 2 at diagnosis, 5 at stage 3, and 4 at stage 4. Totally, we performed 57 cycles of oxaliplatin chemotherapy. Labaratory data and toxicity were assessed for each cycle according to the WHO scale. Ten (10) patients have received follow-up CT since treatment. RESULTS: Grade 1 anemia occurred in 68% of the cycles, grade 2 in 20%, and grade 3 in 12%. Grade 1 thrombocytopenia occurred in 35% of the cycles and grade 2 in 14%. Grade 1 leukopenia and neutropenia occurred in 27% and 25% of the cycles, respectively. Grade 1 stomatitis occurred in 12% of the cycles and grade 2 in 2%. Grade 1 nausea occurred in 44% of the cycles. Grade 1 vomiting occurred in 14% of the cycles and grade 2 in 4%. Grade 1 diarrhea occurred in 10% of the cycles and grade 2 in 4%. Nephrotoxicity was absent, and typical oxaliplatin neurotoxicity was reported as grade 1 in 2% of the cycles. No complete response was observed, and oxaliplatin che motherapy induced one partial remission. CONCLUSION: There was a mild hematologic and alimentary side effect. There were no renal and few neurologic side effects, but the response to oxaliplatin was poor.

Ki 67 Expression and Its Correlation with the Proliferative Index Measured by Flow Cytometry in Breast Carcinoma

PURPOSE: The aim of the present study was to evaluate the clinical utility of Ki 67 labelling index and proliferative indices measured by flow cytometry in breast carcinomas. METHODS: We conducted immunohistochemical assay for Ki 67 and analyzed the DNA content and S-phase fraction by flow cytometry in 113 cases of primary breast carcinomas. Relationship between proliferative indices measured by two method and clinical biological parameters was also analyzed. RESULTS: Ki 67 labelling index than average was increased in 53 tumors (46.9%) and demonstrated a significant correlation with S-phase fraction. Higher Ki 67 labelling index was found in 28 (59.6%) of 47 tumors with high S-phase fraction whereas it was found in only 8 tumors (30.8%) with low S-phase fraction. Concordance between Ki 67 labelling index and S-phase fraction was 63.1% (p=0.017). Tumor with high S-phase fraction had a tendency to have an aneuploid. Ki 67 labelling index correlated significantly with histologic grade (p=0.001) and nuclear grade (p=0.001). An inverse correlation was found between Ki 67 and estrogen receptor expression (p=0.004). CONCLUSION: Ki 67 labelling index significantly correlated with S-phase fraction measured by flow cytometry. Ki 67 labelling index seems to be a clinically useful method because it is rapid, practical and easily performed by immunohistchemical assay.